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From the University of California, San Diego, La Jolla, California, and the San Diego Veterans Affairs Medical Center, San Diego, California. Grant Support: By the Medical Research Service, Department of Veterans Affairs, and the Veterans Affairs Medical Center, San Diego, California. Chronic hyperglycemia is implicated in the pathogenesis of microvascular, neurologic, and macrovascular complications of diabetes.Recent studies prove that near-normal glycemic control in insulin-dependent diabetes mellitus (IDDM) reduces the risk for the development and progression of microvascular and neurologic complications. Diabetes is a metabolic disorder where in human body does not produce or properly uses insulin, a hormone that is required to convert sugar, starches, and other food into energy. Human body has to maintain the blood glucose level at a very narrow range, which is done with insulin and glucagon.
The function of glucagon is causing the liver to release glucose from its cells into the blood, for the production of energy.
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults but was traditionally termed "Juvenile diabetes" because it represents a majority of the diabetes cases in children.
Type 2 Diabetes is also called non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver.
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness.
It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery.
Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia. Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes. It is strongly believed that due to some genes which passes from one generation to another, a person can inherit diabetes. Either physical injury or emotional disturbance is frequently blamed as the initial cause of the disease.


These symptoms are quickly relieved once the Diabetes is treated and also reduce the chances of developing serious health problems. Due to inefficiency of the cell to metabolize glucose, reserve fat of body is metabolized to gain energy. Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to weight loss. The body gives few signals whenever there is fluctuation in blood sugar (due to suppression of immune system) by frequent skin infections like fungal or bacterial or UTI (urinary tract infection). High blood sugar resists the flourishing of WBC, (white blood cell) which are responsible for body immune system.
Diabetes is the primary reason for adult blindness, end-stage renal disease (ESRD), gangrene and amputations. Overweight, lack of exercise, family history and stress increase the likelihood of diabetes.
When blood sugar level is constantly high it leads to kidney failure, cardiovascular problems and neuropathy.
Though, Diabetes mellitus is not completely curable but, it is controllable to a great extent. Vayu, on relative diminution of other two doshas, draws on the dhatus in urinary bladder and thus causes Prameha. There are two types of diabetes : juvenile or insulin dependent diabetes melitus (IDDM) and maturity onset or non-insulin-dependent diabetes mellitus (NIDDM). It is undoubtedly the most serious and complicated, the simple reason of being in the pancreatic beta cells that are completely dead or defective, and therefore do not produce insulin. It afflicts mostly children or young adults and those whose blood sugar levels can not be controlled by pills fall into this category. Henry, MD, Veterans Affairs Medical Center, San Diego (V-111G), 3350 La Jolla Village Drive, San Diego, CA 92161. With the expectation of comparable benefits, similar glycemic goals have been advocated for the management of non–insulin-dependent diabetes mellitus (NIDDM). It depends upon closeness of blood relationship as mother is diabetic, the risk is 2 to 3%, father is diabetic, the risk is more than the previous case and if both the parents are diabetic, the child has much greater risk for diabetes.
This disease may occur at any age, but 80% of cases occur after 50 year, incidences increase with the age factor. New improved blood glucose monitor (new device for self blood glucose monitoring), and hemoglobin A1c laboratory test to measure blood glucose control during previous 3 months. Trishna (Thirst and Polydipsia) : In the process of lypolysis, more water is utilized which results into activation of thirst center in the brain.


SHANER MEHA - Delayed and very slow impulse of urination.patient urinates in less quantity without any urge and difficulty. HASTI MEHA (Prostatitis) - Urine with lasika.In this type, patient urinates urine in a very large quantity just like an elephant. MADHU MEHA (Diabetes mellitus) -In this type, patient urinates urine which is of whitish or yellowish in colour and rough in nature. Boil the 5 leaves each of Tulsi, Neem, Jamun, Bel, with 4 seeds of pepper in a glass of water and drink two times a day. The powder of seeds of Fenugreek (Methi) taken two to three times a day helps control the sugar in blood and urine. However, using intensified insulin therapy to achieve near-normal glycemia in NIDDM may be problematic because of basic differences in the pathophysiology of the two types of diabetes.
Secondly, long standing diabetes leads to thickening of blood vessels which affect proper circulation of blood in different body parts.
This causes disturbance in the equilibrium of dhatus and doshas in the body exposing body to further complications. Most of them develop this type of diabetes when they are around 40 to 50 years of age and, if you follow the proper diet and exercise, can live on tablets without having to take insulin. Insulin resistance is a major contributor to the development of hyperglycemia in NIDDM and may prevent attainment of normoglycemia in most patients who are using the conventional approaches of diet, exercise, and oral hypoglycemic therapy.
Near-normal glycemia in patients with NIDDM can usually be achieved with exogenous insulin but often requires large doses to overcome the insulin resistance. Intensive insulin therapy normalizes glycemia by decreasing hepatic glucose output and improving peripheral glucose uptake and may also improve insulin resistance and insulin secretion by reducing hyperglycemic glucotoxicity.
However, large doses of exogenous insulin are associated with hyperinsulinemia and weight gain, but these effects may be minimized by combining insulin with other forms of therapy, for example, oral antidiabetic agents. When intensive management is instituted, the dose of exogenous insulin should be kept as low as possible. To do this, therapy for NIDDM must be part of a multifaceted approach combining insulin therapy with other effective forms of treatment such as counseling on diet and exercise therapy and the use of oral antidiabetic agents.



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